Akademik Veri Yönetim Sistemi
Turk Plastik, Rekonstruktif ve Estetik Cerrahi Dergisi, cilt.22, sa.3, ss.101-107, 2014 (Scopus)
Purpose: Complications like peri-tendineous adhesion which is followed by tendon rupture is still an important problem in zone-II flexor tendon repairs. To prevent such complications, the strength of repair and providing the early passive and active range- of- motion are basic aspects of the repair. In this study, a new flexor tendon repair method to provide early active mobilization was developed and in vitro biomechanical properties were compared to conventional tendon repair methods. Materials and methods: In this in vitro study, 64 fresh cadaveric sheep flexor tendons obtained from forelegs were randomized in 8 groups. Then tendons were incised and repaired by using two and four-stranded modified Kessler, two and four stranded extra-tendinous suture methods (ETS). In both repairs three subgroups were also created by adding an epitendineous suture to the repairs. The biomechanical support of the epitendineous suture alone was assessed in a separate group. All the repaired tendons were underwent biomechanical stretch test by using a 1kg/N load cell and 20mm/min of constant stretch velocity. Maximal load that cause rupture and knot tightness values were noted. All the data were statistically analyzed by Mann- Whitney-U test for the comparison of independent groups while the rupture rates were analyzed by using the Kruskal-Wallis test. p values smaller than 0.05 was accepted as significant. Results: In double-stranded repairs, the basic mechanism of the rupture was suture detachment while in four stranded repairs it was the suture breakage. Strongest repairs according to their maximal load for rupture and suture tightness values were four-stranded external tendon suture, four-stranded modified Kessler including the epitendineous suture and double-stranded external tendon suture plus epitendineous suture, respectively. Four-stranded external tendon suture was also significantly stronger than other methods in terms of maximal load and suture tightness. Conclusion: In our opinion, external tendon suture method has promising biomechanical results which should be supported by additional in vivo studies before clinical trial to show the biological behavior in early active mobilization.